MR. PANKAJ KUMAR MD
NPI 1639279094
Internal Medicine in Richmond, IN
NPI Status: Active since September 25, 2006
Contact Information
1100 REID PKWY
RICHMOND, IN
ZIP 47374
Phone: (765) 983-3492
Fax: (765) 983-7958
- Individual
- Male
- Years of Experience 46
- Internal Medicine
- Accepts Insurance
- Accepts Medicare Approved Payment
- PECOS Enrolled
- Medicare Quality Reporting
About PANKAJ KUMAR
This page provides the complete NPI Profile along with additional information for Pankaj Kumar, an internist established in Richmond, Indiana with a medical specialization in Internal Medicine and more than 46 years of experience. The healthcare provider is registered in the NPI registry with number 1639279094 assigned on September 2006. The practitioner's primary taxonomy code is 207R00000X with license number 01040839 (IN). The provider is registered as an individual and his NPI record was last updated 4 years ago.
- NPI
- 1639279094
- Provider Name
- MR. PANKAJ KUMAR MD
- Gender
- Male
- Entity Type
- Individual
- Location Address
- 1100 REID PKWY RICHMOND, IN 47374
- Location Phone
- (765) 983-3492
- Location Fax
- (765) 983-7958
- Mailing Address
- 1100 REID PARKWAY MEDICAL STAFF SERVICE RICHMOND, IN 47374
- Mailing Phone
- (765) 935-5331
- Mailing Fax
- (765) 983-7958
- Medical School Name
- OTHER
- Graduation Year
- 1980
- Is Sole Proprietor?
- No
- Enumeration Date
- 09-25-2006
- Last Update Date
- 05-14-2021
- Code Navigator
An internist like Pankaj Kumar is a physician who has completed an internal medicine residency and is board-certified or board-eligible in an internist specialty. Internists are trained to care for adults of all ages for many different medical conditions. An internist typically monitors chronic physical conditions, identifies acute diseases, provides family planning, provides counseling about wellness and disease prevention, etc.
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Internal Medicine
- Taxonomy Code
- 207R00000X
- Type
- Allopathic & Osteopathic Physicians
- License No.
- 01040839
- License State
- IN
- Taxonomy Description
- A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- Anthem Bronze Essential 6500 HSA (+ Incentives) - HMO
- Anthem Bronze Essential 7500 Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
- Anthem Bronze Essential 9200 (+ Incentives) - HMO
- Anthem Bronze Essential 9200 Adult Dental/Vision (+ Incentives) - HMO
- Anthem Bronze Essential POS 5500 ($0 Virtual PCP + $0 Select Drugs + Incentives) - POS
- Anthem Bronze Essential POS 7500 Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - POS
- Anthem Gold Essential 1500 Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
- Anthem Gold Essential 2200 ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
- Anthem Heart Healthy Bronze Essential 4500 ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
- Anthem Heart Healthy Silver Essential 4500 ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
- Bronze First 7500 $25 Generic Drugs - HMO
- Bronze First 7500 $25 Generic Drugs Adult Vision & Fitness - HMO
- Core Gold 1500 $10 Generic Drugs - HMO
- Core Gold 1500 $10 Generic Drugs Adult Vision & Fitness - HMO
- Diabetes Gold 1100 $0 Select Drugs & Specialized Services - HMO
- Diabetes Gold 1100 $0 Select Drugs & Specialized Services Adult Vision & Fitness - HMO
- Diabetes Silver 4000 $0 Select Drugs & Specialized Services - HMO
- Diabetes Silver 4000 $0 Select Drugs & Specialized Services Adult Vision & Fitness - HMO
- Gold 1500 $15 Generic Drugs - HMO
- Gold 1500 $15 Generic Drugs Adult Vision & Fitness - HMO
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
Identifier | Type / Code | Identifier State | Identifier Issuer |
---|---|---|---|
100257230A | MEDICAID (05) | IN | |
110058501 | OTHER (01) | IN | RR MEDICARE |
903830Y | OTHER (01) | IN | REID HOSPITAL-EKG |
000000347061 | OTHER (01) | IN | ANTHEM BCBS PROVIDER PIN |
000000109079 | OTHER (01) | IN | BLUE SHIELD-REID HOSPITAL |
100257230 | MEDICAID (05) | IN | |
1639279094 | OTHER (01) | IN | PECOS |
Medicare Participation & PECOS Enrollment Status
Pankaj Kumar is registered with Medicare and accepts claims assignment, this means the provider accepts the approved amount for the cost of rendered services as full payment. Participating providers may not charge beneficiaries more than the approved amount for their services. Please keep in mind that beneficiaries still have to pay a coinsurance or copayment amount for a visit or service.
Pankaj Kumar is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.
What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.
Is the provider registered in PECOS? Yes
PECOS PAC ID: 6608836606
What is the PECOS Associate Control ID?
A PAC ID is a unique 10-digit number assigned to an individual or organization healthcare provider in PECOS. The PAC ID is used to link together all the provider information, like tax identification numbers and organizational names. A PAC ID can be connected to multiple Enrollment IDs if an individual or organization has enrolled in PECOS more than once.PECOS Enrollment ID: I20041014000221
What is the Provider Enrollment ID?
The Enrollment ID is a unique alphanumeric 15-digit code assigned to each new provider's PECOS enrollment application. The Enrollment ID is used to link together all the provider enrollment information like enrollment type, state, provider specialty, and reassignment of benefits.Accepts Medicare Assignment? Yes
What does it mean "accepts medicare assignment"?
When a provider accepts Medicare assignment, the provider agrees to be paid directly by Medicare and to accept the payment amount approved by Medicare. Additionally, the provider agrees to not bill patients for more than the Medicare deductible and coinsurance amounts.
A provider who doesn't accept assignment may charge you up to 15% over the Medicare-approved amount. This is known as the limiting charge. You may have to pay this amount, or it may be covered by another insurer.Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes
Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes
Eligible to Order or Refer a Home Health Agency (HHA): Yes
Eligible to Order or Refer Power Mobility Devices: Yes
Provider Referred Orders for Durable Medical Equipment, Devices & Supplies
The following list reflects the services, supplies or durable medical equipment ordered by this provider to a DME supplier on behalf of patients. The information below is derived from Medicare claims data and reflects the BETOS category, HCPCS code information and the number times each service was submitted under the Medicare fee-for-service program.
Durable Medical Equipment
DME-Other DME (DE001N)
Tubing with integrated heating element for use with positive airway pressure device (HCPCS:A4604)
2 DME suppliers used 11 Medicare Claims 11 Services Paid
DME-Other DME (DE001N)
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap (HCPCS:A7034)
2 DME suppliers used 14 Medicare Claims 14 Services Paid
DME-Other DME (DE001N)
Headgear used with positive airway pressure device (HCPCS:A7035)
2 DME suppliers used 14 Medicare Claims 14 Services Paid
DME-Other DME (DE001N)
Filter, disposable, used with positive airway pressure device (HCPCS:A7038)
2 DME suppliers used 22 Medicare Claims 125 Services Paid
DME-Other DME (DE001N)
Water chamber for humidifier, used with positive airway pressure device, replacement, each (HCPCS:A7046)
2 DME suppliers used 12 Medicare Claims 12 Services Paid
DME-Oxygen and Supplies (DC000N)
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing (HCPCS:E0431)
2 DME suppliers used 99 Medicare Claims 99 Services Paid
DME-Other DME (DE005N)
Home ventilator, any type, used with non-invasive interface, (e.g., mask, chest shell) (HCPCS:E0466)
1 DME suppliers used 12 Medicare Claims 12 Services Paid
DME-Other DME (DE000N)
Compressor, air power source for equipment which is not self-contained or cylinder driven (HCPCS:E0565)
1 DME suppliers used 11 Medicare Claims 11 Services Paid
DME-Other DME (DE000N)
Respiratory suction pump, home model, portable or stationary, electric (HCPCS:E0600)
1 DME suppliers used 11 Medicare Claims 11 Services Paid
DME-Oxygen and Supplies (DC002N)
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate (HCPCS:E1390)
2 DME suppliers used 90 Medicare Claims 90 Services Paid
Areas of Expertise
The following services and procedures, recently provided to Medicare patients, illustrate the range of care this provider offers. This list reflects the variety of services available to all patients visiting the practice and is based on 2022 Medicare dataset. In general, the more frequently a provider treats specific conditions or performs particular procedures, the more experienced they become in addressing similar patient needs. The provider has delivered many of the services listed below to Medicare patients. Please note that this list does not include services provided to patients who are not covered by Medicare.
Follow-up hospital inpatient care per day, typically 15 minutes
Follow-up hospital inpatient care per day, typically 25 minutes
Follow-up hospital inpatient care per day, typically 35 minutes
Hospital discharge day management, more than 30 minutes
Hospital observation care on day of discharge
Initial hospital inpatient care per day, typically 30 minutes
Initial hospital inpatient care per day, typically 70 minutes
Initial hospital observation care per day, typically 30 minutes
Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report only
Follow-up hospital inpatient care is a daily service where a healthcare professional checks on your health progress during your hospital stay. Each session typically lasts 15 minutes, involving updates on your condition and adjustments to your treatment plan, if necessary.
This service was performed 53 times for 36 patientsFollow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.
This service was performed 406 times for 210 patientsFollow-up hospital inpatient care per day typically involves a 35-minute check-up by your healthcare provider. This service includes monitoring your health progress, adjusting your treatment plan if needed, and answering any questions you may have about your condition or care.
This service was performed 217 times for 124 patientsHospital discharge day management over 30 minutes involves a detailed process to ensure a smooth transition from hospital to home. It includes final examinations, discussion of your hospital stay, post-discharge instructions, and coordinating follow-up care.
This service was performed 244 times for 233 patientsHospital observation care on the day of discharge involves monitoring your health status to ensure stability before you leave. This includes assessing vital signs, response to treatment, and readiness for home care or rehabilitation.
This service was performed 54 times for 54 patientsInitial hospital inpatient care refers to the first day of your stay in the hospital. This service typically includes a 30-minute check-up with a healthcare professional. They'll assess your health, discuss your condition, and plan your treatment. It's part of ensuring you receive the best possible care.
This service was performed 17 times for 17 patientsInitial hospital inpatient care per day, typically 70 minutes, refers to the daily medical service provided to patients admitted to the hospital. This includes a comprehensive evaluation, diagnosis, treatment plan, and monitoring of your health condition. It ensures your well-being during your hospital stay.
This service was performed 39 times for 39 patientsInitial hospital observation care is a service where a healthcare provider monitors your health condition daily for about 30 minutes. It's essential to track your progress, adjust your treatment if needed, and ensure your safety during your hospital stay.
This service was performed 11 times for 11 patientsA routine electrocardiogram (ECG) with 12 leads is a simple, non-invasive test that records the electrical activity of your heart. It helps in identifying heart conditions by detecting irregularities in your heart rhythms. The results are interpreted and a report is provided.
This service was performed 1,062 times for 831 patientsPhysician Visit Costs
The typical physician office visit costs for Medicare beneficiaries in this area are: $30.62 for a new patient copayment and $23.55 for an established patient copayment.
The pricing information below displays the copayment minimum, maximum and average amount that patients under Medicare are charged when visiting this provider as a new or established patient. Please keep in mind that these prices are just for reference purposes, and the actual prices charged by the provider might be different.
For patients covered under private health plans the prices below are also useful as healthcare pricing for private insurance is usually established as a function of Medicare prices. Private insurance covered patients should check their individual plans to determine the exact pricing.
The prices below reflect the costs for new and established patients in the 47374 ZIP code area.
New Patients Visit Costs *
The most utilized procedure code for new patients office visits is 99204
- Average New Patient Price $122.49
- Minimum New Patient Price $53.07
- Maximum New Patient Price $161.76
- Average New Patient Copayment $30.62
- Minimum New Patient Copayment $13.26
- Maximum New Patient Copayment $40.44
Established Patients Visit Costs *
The most utilized procedure code for established patients office visits is 99214
- Average Established Patient Price $94.22
- Minimum Established Patient Price $16.93
- Maximum Established Patient Price $132.22
- Average Established Patient Copayment $23.55
- Minimum Established Patient Copayment $4.23
- Maximum Established Patient Copayment $33.05
* The physician office visit costs information is generated by statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.
Quality Reporting
The provider participated in CMS Quality Payment Program. The Quality Payment Program aims to improve population health, reduce costs and improve the care received by Medicare beneficiaries. The following quality measures meet Medicare's statistical reporting standards. Not all providers report the same information, because not all providers give the same services to patients. The quality information is just a snapshot of some the care providers give to their patients. Reporting more or less information is not a reflection of quality.
Quality Measure | Performance | Number of Patients |
---|---|---|
e-Prescribing | 62% | 8776 |
At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using certified EHR technology. | ||
Provide Patient Access | 69% | 1159 |
For at least one unique patient seen by the MIPS eligible clinician: (1) The patient (or the patient authorized representative) is provided timely access to view online, download, and transmit his or her health information; and (2) The MIPS eligible clinician ensures the patient's health information is available for the patient (or patient-authorized representative) to access using any application of their choice that is configured to meet the technical specifications of the Application Programing Interface (API) in the MIPS eligible clinician's certified EHR technology. | ||
Security Risk Analysis | Yes | N/A |
Conduct or review a security risk analysis in accordance with the requirements in 45 CFR 164.308(a)(1), including addressing the security (to include encryption) of ePHI data created or maintained by certified EHR technology in accordance with requirements in 45 CFR164.312(a)(2)(iv) and 45 CFR 164.306(d)(3), and implement security updates as necessary and correct identified security deficiencies as part of the MIPS eligible clinician's risk management process. |
Find Provider Hospital Affiliations - Privileges
Doctors and physicians must apply for hospital privileges to treat patients at hospitals. Find out if your doctor has privileges to practice at your preferred hospital by using the hospital affiliation information below based on recent medical claims.
Hospital affiliation is identified through self-reporting data, inpatient, outpatient, physician and ancillary service claims linked by the medical claims NPI number and place of service code. Additionally, to further determine provider hospital affiliation the clinician must have provided services to at least three patients on three different dates in the last 12 months. Pankaj Kumar is affiliated with the following medical facilities:
Hospital Name | Address | Phone | Hospital Type | Overall Rating |
---|---|---|---|---|
REID HEALTH | 1100 REID PKWY RICHMOND, IN 47374 | (765) 983-3000 | Acute Care Hospitals |
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NPI Validation Check Digit Calculation
The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.
Start with the original NPI number, the last digit is the check digit and is not used in the calculation. | |||||||||
1 | 6 | 3 | 9 | 2 | 7 | 9 | 0 | 9 | 4 |
Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
2 | 6 | 6 | 9 | 4 | 7 | 18 | 0 | 18 | |
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
2 + 6 + 6 + 9 + 4 + 7 + 1 + 8 + 0 + 1 + 8 + 24 = 76 | |||||||||
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
80 - 76 = 4 | 4 |
The NPI number 1639279094 is valid because the calculated check digit 4 using the Luhn validation algorithm matches the last digit of the original NPI number.
Other Providers at the Same Location
The following 20 providers are registered at the same or nearby location.
NPI | Name / Type | Taxonomy | Address |
---|---|---|---|
1003873795 | THOMAS P. GLYNN JR. M.D. Individual | Radiology (Diagnostic Radiology) | 1100 REID PKWY RICHMOND, IN 47374 (765) 983-3000 |
1154350411 | REID HOSPITAL & HEALTH CARE SERVICES INC Organization | Anesthesiology | 1100 REID PKWY RICHMOND, IN 47374 (765) 983-3307 |
1437299070 | REID HOSPITAL & HEALTH CARE SERVICES Organization | Plastic Surgery | 1100 REID PKWY RICHMOND, IN 47374 (765) 962-6053 |
1447383898 | REID HOSPITAL & HEALTH CARE SERVICES INC Organization | Physical Therapist (Pediatrics) | 1100 REID PKWY RICHMOND, IN 47374 (765) 983-3123 |
1750656146 | EMERGENCY MEDICINE OF EASTERN INDIANA, P.C. Organization | Emergency Medicine | 1100 REID PKWY RICHMOND, IN 47374 (765) 983-3144 |
1508070012 | HEIDI SARABIA M.D. Individual | Anesthesiology | 1100 REID PKWY REID ANESTHESIA RICHMOND, IN 47374 (765) 935-8747 |
1730267063 | CARMEN VENABLE RD, CD Individual | Dietitian, Registered | 1100 REID PKWY SUITE 300 RICHMOND, IN 47374 (765) 983-3423 |
1073511556 | RONALD VIERK MD Individual | Anesthesiology | 1100 REID PKWY SURGERY/ANESTHESIA DEPARTMENT RICHMOND, IN 47374 (765) 935-8747 |
1891790176 | WILLIAM M DUCEY M.D. Individual | Surgery (Vascular Surgery) | 1100 REID PKWY SUITE 215 RICHMOND, IN 47374 (765) 939-9331 |
1063457380 | REID HOSPITAL & HEALTH CARE SERVICES, INC Organization | General Acute Care Hospital | 1100 REID PKWY RICHMOND, IN 47374 (765) 983-3000 |
1447288766 | REID HOSPITAL & HEALTH CARE SERVICES, INC. Organization | Rehabilitation Unit | 1100 REID PKWY RICHMOND, IN 47374 (765) 983-3307 |
1265461511 | REID HOSPITAL & HEALTH CARE SERVICES, INC Organization | Psychiatric Unit | 1100 REID PKWY RICHMOND, IN 47374 (765) 983-3307 |
1982633236 | REID HOSPITAL & HEALTH CARE SERVICES INC Organization | Internal Medicine | 1100 REID PKWY RICHMOND, IN 47374 (765) 983-3300 |
1275901001 | MIRANDA DAWN PASSMORE P.T. Individual | Physical Therapist | 1100 REID PKWY RICHMOND, IN 47374 (765) 983-3092 |
1801929245 | REID HOSPITAL & HEALTH CARE SERVICES INC Organization | Non-Pharmacy Dispensing Site | 1100 REID PKWY RICHMOND, IN 47374 (765) 983-3123 |
1265689111 | REID PHYSICIAN ASSOCIATES, INC. Organization | Internal Medicine | 1100 REID PKWY RICHMOND, IN 47374 (765) 983-3127 |
1841255940 | DR. MORGAN A MONCADA MD Individual | Hospitalist | 1100 REID PKWY RICHMOND, IN 47374 (765) 983-3492 |
1831287598 | XINQIANG HAN M.D. Individual | Internal Medicine (Clinical Cardiac Electrophysiology) | 1100 REID PKWY SUITE 210 RICHMOND, IN 47374 (765) 962-1337 |
1801891189 | MICHAEL J BUCKMASTER M.D. Individual | Surgery (Vascular Surgery) | 1100 REID PKWY SUITE 215 RICHMOND, IN 47374 (765) 939-9331 |
1396296109 | JESSE TITTLE ATC, LAT Individual | Specialist/Technologist (Athletic Trainer) | 1100 REID PKWY RICHMOND, IN 47374 (765) 983-3092 |
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1639279094, enumerated in the NPI registry as an "individual" on September 25, 2006
The provider is located at 1100 Reid Pkwy Richmond, In 47374 and the phone number is (765) 983-3492
The provider's speciality is Internal Medicine with taxonomy code 207R00000X
The provider has more than 46 years of experience.
The provider might be accepting Accepts: Anthem Blue Cross and Blue Shield, CareSource,. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.
Yes, as of June 20, 2025 the provider is registered in PECOS and is eligible to order health care services or supplies for Medicare patients. If you are a beneficiary the provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.
Medicare beneficiaries should expect a typical cost of $122.49 with an average copayment of $30.62 for new patient appointments. Established patients should expect a typical charge of $94.22 and an average copayment of 23.55. Please review your insurance plan or contact the provider directly to determine your specific costs.
The most common procedures or services performed by this practitioner are: Follow-up hospital inpatient care per day, typically 15 minutes, Follow-up hospital inpatient care per day, typically 25 minutes, Follow-up hospital inpatient care per day, typically 35 minutes, Hospital discharge day management, more than 30 minutes, Hospital observation care on day of discharge, Initial hospital inpatient care per day, typically 30 minutes, Initial hospital inpatient care per day, typically 70 minutes, Initial hospital observation care per day, typically 30 minutes and Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report only.
The practitioner is affiliated to the following hospital(s): REID HEALTH. Hospital affiliations are identified through self-reporting data and service claims based on the place of service.
This NPI record was last updated on September 25, 2006. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
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